Causes, Symptoms, and Treatment Options for Back Pain & Sciatica

TOPICS:
1. Overview of Back Pain
2. Anatomy of the Spine
3. Causes of Back Pain
4. What are the Symptoms associated with Back Pain?
5. When should I see a Pain Specialist?
6. What tests do I need?
7. How is Back Pain treated?
8. How can I avoid surgery?
9. How can I avoid worsening or relapse of my back pain?

Overview of Back Pain

Back pain is a very common condition. Close to 80% of patients will have low back pain during their life time. In most circumstances, the back pain does not represent a serious medical issue and oftentimes, resolves on its own. However, it can interfere with your activities of daily living and affect your quality of life. 

Anatomy of the Spine

The spine, often referred to as the backbone or vertebral column, is the central support structure of the body. It extends from the base of the skull to the pelvis and is composed of a series of small bones called vertebrae. These vertebrae are stacked on top of each other, forming a flexible rod-like structure that helps us stand upright and move around.

The spine serves several important functions. It provides support for the weight of the body and also protects the delicate spinal cord, which is a bundle of nerves that carries messages between the brain and the rest of the body.

The spine is divided into several sections, including the cervical spine in the neck, the thoracic spine in the upper and middle back, the lumbar spine in the lower back, and the sacrum and coccyx at the base. The spine is made up of multiple circular shaped bones called vertebrae. Between each pair of vertebrae are cushiony discs called intervertebral discs, which act as shock absorbers and allow for flexibility and movement. Surrounding the spine are muscles, ligaments, and tendons that help support and stabilize it, making it a vital part of the body's structure and function.

Causes of Pain

The back is a complicated structure with many structures that are rich with nerves. Any of these structures, when injured or degenerated, can cause pain. These structures include:

• Vertebrae
• Discs
• Facet Joints
• Ligaments
• Muscles
• Spinal Cord & Spinal Nerves

What are the Symptoms associated with Back Pain?

Most commonly, back pain is felt in the lower back. However, it can range from anywhere from the bottom of the neck to your bottom. It can occur with or without injury.

Back pain is often associated with other symptoms such as:

• Pain radiating from the back / buttock to the feet
• Pins and needles in the leg
• Numbness in the leg
• Weakness in the leg

When should I see a Pain Specialist?

Back pain is a common condition. In most cases, the pain resolves within a week or two. If the pain is persistent, you may want to visit a Pain Specialist. A Pain Specialist can help you to:

• Exclude a serious illness
• Find out the root cause for your low back pain
• Offer you further investigations (eg. X-ray, MRI scans & Diagnostic blocks) to pinpoint the root cause of your low back pain
• Eliminate or Reduce the severity of your low back pain using a combination of:
  • Medications
  • Exercises
  • Minimally Invasive Procedures (non-operative)
  • If needed (eg. if surgery is required), you may be referred to other doctors such as Neurologists & Spine Surgeons.

What tests do I need?

The test that you will need depends on what is discovered during history & physical examination. Common tests include:

• Blood tests
• Ultrasound studies
• Radiological investigations (such as X-rays, MRI scans & CT Scans)
• Nerve Conduction Studies
• Diagnostic blocks

How is Back Pain treated?

Given the many different causes of Back Pain, there is no one-size-fits-all treatment. In many patients, the Back Pain spontaneously resolves within 1 to 2 weeks. In these cases, all that is required are some over-the-counter pain relievers (eg. Ibuprofen / Paracetamol). However, if the back pain persists, further treatment will be guided by findings from your Pain Specialist Consultation.

These treatments include:​

• Medications
• Exercises
• Minimally Invasive Procedures (non-operative)
• If needed (eg, if surgery is required), you may be referred to other doctors such as Neurologists & Spine Surgeons.

How can I avoid surgery?

Most patients with back pain can be treated with a combination of medications, exercises and minimally invasive procedures (non-operative). However, a small subgroup of patients have inadequate response to such conservative treatment and may need to have surgery. It is important to speak to your Pain Specialist to find out which minimally invasive procedure can benefit you. 

How can I avoid a worsening or relapse of my back pain?

​To avoid worsening or relapse of your back pain, consider implementing the following strategies:

• Maintain Good Posture 
• Exercise Regularly (core-strengthening exercises, stretching, and low-impact aerobic activities like walking or swimming)
• Avoid Prolonged Sitting
• Lift Properly
• Maintain a Healthy Weight
• Use Proper Body Mechanics
• Manage Stress
• Listen to Your Body (Pay attention to warning signs of impending back pain, such as stiffness, discomfort, or fatigue. Take breaks when needed, and don't push through pain)
  
  

By incorporating these strategies into your daily routine, you can help prevent worsening or relapse of your back pain and maintain a healthy and active lifestyle. If you experience persistent or severe back pain, consult with a healthcare professional for proper evaluation and treatment.

Dr Christopher Liu is a Pain Specialist based in Singapore. He sees patients with Back Pain and offers a number of Minimally Invasive Procedures for this condition. 

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